Psychological approach alters pain perception in fibromyalgia

Psychological therapy may alter pain processing in the spinal cord and potentially reduce the symptoms of fibromyalgia, a new study has concluded. A total of 32 patients with fibromyalgia were randomised to six weekly sessions of cognitive behavioural therapy (CBT) or usual care. CBT addressed issues such as activity pacing, the scheduling of pleasant activities, relaxation, automatic thoughts about pain, cognitive restructuring and stress management. The nociceptive flexion reflex (NFR) threshold was used as an objective measure of pain perception. The test measured the level of stimulation of a sensory nerve required to elicit a spinal withdrawal reflex. CBT significantly increased the NFR threshold at six weeks, indicating that pain sensitivity had been reduced by the treatment. The benefit persisted at 12 weeks. Both groups reported similar reductions in NFR pain ratings at week 6, but by this point the CBT group was receiving more intense stimuli. “This is the first study to offer evidence of a biological effect of a psychological-based therapy in the management of chronic fibromyalgia pain,” the researchers concluded. A second report, based on a population survey in Norway, found fibromyalgia was more common in women who were overweight and/or inactive. It was possible that chronic inflammation associated with obesity also increased the risk of fibromyalgia, and that exercise had an analgesic effect. Arthritis Care and Research 2010; published online....